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Clinical Toxicology

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https://www.readbyqxmd.com/read/28541143/an-algorithm-for-identifying-mothball-composition
#1
Michael J Moss, Kevin F Maskell, Michelle A Hieger, Brandon K Wills, Kirk L Cumpston
INTRODUCTION: Unintentional mothball ingestions may cause serious toxicity in small children. Camphor, naphthalene, and paradichlorobenzene mothballs are difficult to distinguish without packaging. Symptoms and management differ based on the ingested compound. Previous studies have used a variety of antiquated, impractical and potentially dangerous techniques to identify the mothballs. The goal of this study is to discover a simplified identification technique using materials readily available in an emergency department...
May 25, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535126/activated-charcoal-significantly-reduces-the-amount-of-colchicine-released-from-gloriosa-superba-in-simulated-gastric-and-intestinal-media
#2
Shukry Zawahir, Indika Gawarammana, Paul I Dargan, Mahfoudh Abdulghni, Andrew H Dawson
BACKGROUND: Poisoning with Gloriosa superba, a plant containing colchicine, is common in Sri Lanka. OBJECTIVES: This study was to estimate release of colchicine from 5 g of different parts of Gloriosa superba in simulated gastric and intestinal media, and examine the binding efficacy of activated charcoal (AC) to colchicine within this model. METHODS: A USP dissolution apparatus-II was used to prepare samples for analysis of colchicine using HPLC...
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535124/serum-creatinine-and-cystatin-c-provide-conflicting-evidence-of-acute-kidney-injury-following-acute-ingestion-of-potassium-permanganate-and-oxalic-acid
#3
Thilini Madushanka Wijerathna, Indika Bandara Gawarammana, Dhammika Menike Dissanayaka, Chathura Palanagasinghe, Fathima Shihana, Gihani Dassanayaka, Seyed Shahmy, Zoltan Huba Endre, Fahim Mohamed, Nicholas Alan Buckley
AIM: Acute kidney injury (AKI) is common following deliberate self-poisoning with a combination washing powder containing oxalic acid (H2C2O4) and potassium permanganate (KMnO4). Early and rapid increases in serum creatinine (sCr) follow severe poisoning. We investigated the relationship of these increases with direct nephrotoxicity in an ongoing multicenter prospective cohort study in Sri Lanka exploring AKI following poisoning. METHODS: Multiple measures of change in kidney function were evaluated in 48 consenting patients who had serial sCr and serum cystatin C (sCysC) data available...
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535122/methylphenidate-poisoning-relatively-mild-symptoms-even-after-high-dose-exposure
#4
Saskia J Rietjens, Laura Hondebrink, Terry Jorna, Irma de Vries
No abstract text is available yet for this article.
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535116/is-mannitol-the-treatment-of-choice-for-patients-with-ciguatera-fish-poisoning
#5
Michael E Mullins, Robert S Hoffman
CONTEXT: Ciguatera fish poisoning arises primarily from consumption of carnivorous reef fish caught in tropical and sub-tropical waters. Ciguatoxins, a class of tasteless, heat-stable, polycyclic toxins produced by dinoflagellates, accumulate through the food chain and concentrate in various carnivorous fish, such as groupers, barracudas, wrasses, amberjack, kingfishes, and eels. Characteristics of ciguatera fish poisoning include early nausea, vomiting, and diarrhea in the first one to two days post ingestion, followed by the appearance of sensory disturbances...
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535083/reply-to-hoegberg-et-al-letter-in-response-to-lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#6
Michael R Fettiplace
No abstract text is available yet for this article.
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28535077/sticky-situations-cyanoacrylate-exposures-reported-to-a-poison-control-system
#7
Shaun D Carstairs, Cynthia Koh, Lily Qian, Mariam Qozi, Grant Seivard, F Lee Cantrell
INTRODUCTION: Cyanoacrylate (Super Glue(®)) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures. We sought to characterize cyanoacrylate exposures reported to a poison control system. METHODS: We performed a retrospective review of a poison system's database for all cases of single-substance human exposure to cyanoacrylate-containing products from 2005 to 2015. Data collected included age, gender, route of exposure, clinical effects, treatments recommended and medical outcome...
May 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28494183/resolution-of-cannabis-hyperemesis-syndrome-with-topical-capsaicin-in-the-emergency-department-a-case-series
#8
Laurel Dezieck, Zachary Hafez, Albert Conicella, Eike Blohm, Mark J O'Connor, Evan S Schwarz, Michael E Mullins
BACKGROUND: Cannabinoid hyperemesis syndrome (CHS) is characterized by symptoms of cyclic abdominal pain, nausea, and vomiting in the setting of prolonged cannabis use. The transient receptor potential vanilloid 1 (TRPV1) receptor may be involved in this syndrome. Topical capsaicin is a proposed treatment for CHS; it binds TRPV1 with high specificity, impairing substance P signaling in the area postrema and nucleus tractus solitarius via overstimulation of TRPV1. This may explain its apparent antiemetic effect in this syndrome...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28494178/suicide-attempt-with-self-made-taxus-baccata-leaf-capsules-survival-following-the-application-of-extracorporeal-membrane-oxygenation-for-ventricular-arrythmia-and-refractory-cardiogenic-shock
#9
Fanny Vardon Bounes, Elsa Tardif, Stéphanie Ruiz, Jean-Christophe Gallart, Jean-Marie Conil, Clément Delmas
CONTEXT: Yew intoxication has been known for many years; high dose ingestion of Taxus baccata leads to cardiac toxicity mediated by calcium and sodium channel blocking properties. We present a case report of a patient who attempted suicide after T. baccata ingestion, causing refractory cardiogenic shock requiring temporary circulatory assistance by veno-arterial extra corporeal membrane oxygenation (VA ECMO). CASE DETAILS: A 28-year-old man was admitted to the critical care unit of a university hospital for arrhythmia after ingestion of self-made T...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28494175/the-effect-of-plasmapheresis-on-treating-disseminated-intravascular-coagulation-dic-caused-by-a-hemiscorpius-lepturus-gadim-sting
#10
Babak Mostafazadeh, Ahmad Gorbani, Mitra Mogaddaspour, Hamid Reza Khoddami Vishteh
INTRODUCTION: The highest mortality from scorpion stings in Iran is due to the stings of a particular type of scorpion known as Hemiscorpius lepturus (H. lepturus, Gadim in local language). The present study aimed at investigating the use of plasmapheresis to treat severe cases of H. lepturus stings. METHOD: This pilot study was a randomized clinical trial conducted from June 2015 to June 2016 in Razi hospital of Ahvaz, Iran. Twenty-nine patients who had been stung by H...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28494173/suicide-attempt-with-acetonitrile-ingestion-in-a-nursing-mother
#11
Eduardo Mello De Capitani, Carla Fernanda Borrasca-Fernandes, Maíra Branco Pimenta, Camila Carbone Prado, Paula Christiane Soubhia, Rafael Lanaro, Sueli Mello Moreira, Rafael Linden, Helena Valle Nóbrega, Fábio Bucaretchi, José Luiz Costa
CONTEXT: Acetonitrile (ACN) is a solvent rapidly absorbed through lungs and intestinal tract, and is slowly metabolized to cyanide (CN) by enzymatic processes mediated by CYP2E1. OBJECTIVE: To describe the clinical and laboratory evolution, ACN elimination half-life, and its presence in breast milk in a nursing mother who attempted suicide. CASE DETAILS: A 25-year-old 2-month nursing mother ingested an estimated dose of 2.1 g/kg of ACN. Blood and urine samples were collected 24 h later for ACN, CN and thiocyanate analysis, and 12...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28471310/medication-organizers-pill-minders-increase-the-risk-for-unintentional-pediatric-ingestions
#12
George Sam Wang, Jason A Hoppe, Lina Brou, Kennon J Heard
OBJECTIVE: Medication organizers may help improve medication compliance; however, they may increase the risk of having an unintentional pediatric exposure. The objective of this study was to measure the association between a pediatric emergency department (ED) visit for an unintentional pharmaceutical ingestion and the use of a medication organizer in the household. METHODS: This was a cross-sectional case control study at a tertiary care children's hospital ED...
May 4, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28471280/bad-trip-due-to-25i-nbome-a-case-report-from-the-eu-project-spice-ii-plus
#13
Maren Hermanns-Clausen, Verena Angerer, Josephine Kithinji, Christina Grumann, Volker Auwärter
OBJECTIVE: The potent hallucinogenic drug 25I-NBOMe has recently emerged on the drug market. We present a case with analytically confirmed 25I-NBOMe intoxication from the prospective study "SPICE II Plus". CASE REPORT: Because of a severe headache a 42-year-old man took one sip of a pediatric analgesic syrup, which had been refilled with a self-made solution of 25I-NBOMe in ethanol. Thirty minutes later restlessness occurred. On arrival in the emergency department mydriasis, strong sweating, disorientation, and agitation were noticed...
May 4, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28467236/letter-in-response-to-lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#14
Lotte C G Hoegberg, Robert S Hoffman, Bryan D Hayes, Valéry Lavergne, Sophie Gosselin
No abstract text is available yet for this article.
May 3, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28463024/delayed-genital-blisters-following-iodixanol-administration
#15
Wen Zhang, Wei Yuan, Hai-Ling Yuan, Xiao-Lai Yang, Hua Xie
Iodixanol is a non-ionic contrast medium for general vascular use. The most common adverse effects from iodixanol include skin rashes, hives, erythema, itching, and angioedema. To date, there have been no reports of delayed genital blisters of iodixanol. In this report, we describe a patient in whom iodixanol induced delayed genital blisters one day after digital subtraction angiography.
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28463019/fatal-cardiac-glycoside-poisoning-due-to-mistaking-foxglove-for-comfrey
#16
I-Lin Wu, Jiun-Hao Yu, Chih-Chuan Lin, Chen-June Seak, Kent R Olson, Hsien-Yi Chen
CONTEXT: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CASE DETAILS: A 55-year-old woman presented to the emergency department with nausea, vomiting and generalized weakness eight hours after drinking "comfrey" tea...
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28463017/unintentional-ingestion-of-cordyceps-fungus-infected-cicada-nymphs-causing-ibotenic-acid-poisoning-in-southern-vietnam
#17
Uyen Vy Doan, Bomar Mendez Rojas, Ralph Kirby
BACKGROUND: Cordyceps fungus found in infected cicada nymphs ("cicada flowers") is utilized in traditional Chinese medicine. Cordyceps fungus toxicity in humans has not been previously reported. We report 60 cases of apparent Cordyceps poisoning in Southern Vietnam. METHODS: We retrospectively collected demographic and clinical data from the medical records (21 cases) and by telephone interview (39 cases) of patients admitted to seven hospitals in Southern Vietnam following ingestion of cicada flowers between 2008 and 2015...
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28463016/corrigendum
#18
(no author information available yet)
No abstract text is available yet for this article.
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28447890/response-to-the-letter-regarding-is-it-really-safe-to-withhold-folinic-acid-when-less-than-1000%C3%A2-mg-m-2-methotrexate-is-ingested
#19
Betty S Chan, Andrew H Dawson, Nicholas A Buckley
No abstract text is available yet for this article.
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28447886/drug-induced-hyperlactatemia
#20
Eike Blohm, Jeffrey Lai, Mark Neavyn
BACKGROUND: Hyperlactatemia is common in critically ill patients and has a variety of etiologies. Medication toxicity remains an uncommon cause that providers often fail to recognize. In this article, we review several medications that cause hyperlactatemia in either therapeutic or supratherapeutic dosing. When known, the incidence, mortality, pathophysiology, and treatment options are discussed. METHODS: We performed a literature search using PUBMED and Google Scholar for English language articles published after 1980 regarding medication induced hyperlactatemia and its management...
April 27, 2017: Clinical Toxicology
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